The hospice nurse is working with a volunteer.
Which task could the nurse delegate to the volunteer?

Management of nephrotic syndrome involves using ACE inhibitors for their antiproteinuric and renoprotective effects. One must understand the therapeutic goals of lisinopril in renal disease and the necessity of medication adherence and safety monitoring to provide accurate education.

Choice A rationale

Stopping lisinopril abruptly is dangerous and requires medical supervision. Patients must understand that swelling fluctuations should be reported to the provider rather than used as a reason to self-discontinue a critical medication for renal health.

Choice B rationale

Lisinopril, an ACE inhibitor, reduces the glomerular basement membrane permeability and lowers the pressure within the glomeruli. This action effectively decreases the amount of protein that leaks into the urine, which is a hallmark of syndrome.

Choice C rationale

By reducing intraglomerular pressure and decreasing proteinuria, ACE inhibitors help slow the progression of chronic kidney disease. This protective mechanism is vital for patients with nephrotic syndrome to preserve long-term renal function and prevent scarring.

Choice D rationale

Hypertension is a common complication and contributing factor in nephrotic syndrome. Lisinopril manages systemic blood pressure by inhibiting the conversion of angiotensin I to angiotensin II, which prevents vasoconstriction and lowers the overall vascular resistance..

Determining priority assessments in hospice care requires applying Maslow's hierarchy and the nursing process. Understanding the medical diagnosis is foundational for anticipating physical needs, managing symptoms, and ensuring safety, which precedes addressing psychosocial, spiritual, or financial concerns during the initial admission phase.

Choice A rationale

Identifying the medical diagnosis is essential for clinical decision making and symptom management. It allows the nurse to anticipate complications, understand prognosis, and provide appropriate pharmacological interventions to ensure comfort, which is the primary goal of hospice.

Choice B rationale

While financial stability affects long term care planning, it is not the immediate clinical priority upon admission. Basic physiological needs and medical stability must be addressed before the nurse evaluates the client's insurance coverage or socioeconomic status.

Choice C rationale

Spiritual assessment is a core component of holistic hospice care, yet it follows physical stabilization. The nurse must first ensure the client is not in acute physical distress before exploring religious beliefs or existential concerns.

Choice D rationale

Assessing the support system is vital for planning home care and caregiver respite. However, without understanding the medical condition first, the nurse cannot accurately determine the level of support or specific skills the family needs.